Positron Emission Tomography with 18F-Fluorodeoxyglucose of Uterine Sarcoma: A Comparison with Magnetic Resonance Imaging and Power Doppler Imaging

Umesaki, Naohiko; Tanaka, Tetsuji; Miyama, Masato; Kawamura, Naoki; Ogita, Sachio; Kawabe, Jyoji; Okamura, Terue; Koyama, Koichi; Ochi, Hironobu

doi:10.1006/gyno.2000.6081

Cited by 135 publications

(52 citation statements)

References 9 publications

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“…9,10 Emoto et al 11 reported the vascular features as assessed by Doppler sonography of 2 cases of uterine carcinosarcoma. They found that these tumors typically show irregular, thin, and randomly dispersed vessels in either peripheral or central areas, or both, of the tumor, confirming previous findings reported by Kurjak et al 9 ; however, Umesaki et al, 12 when analyzing a case of uterine carcinosarcoma, reported that vascularization was mainly peripheral.…”

Section: Discussionsupporting

confidence: 77%

Uterine Carcinosarcoma Arising From an Endometrial Polyp

Nieves-Lugo¹,

Blanch²,

Abad³

et al. 2006

Journal of Ultrasound in Medicine

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terine carcinosarcomas are uncommon malignant tumors, characterized histologically by the presence of both malignant glandular and sarcomatous components.1 They are also called malignant mixed müllerian tumors and usually appear in postmenopausal women.1 Most of them have a highly aggressive behavior, and their prognosis used to be very poor, even in stage I.2,3 Traditionally, these tumors have been considered a subtype of uterine sarcoma; however, recent data have shown that most carcinosarcomas have a monoclonal origin. 4Specific preoperative diagnosis is often very difficult because, in most instances, an endometrial biopsy specimen can indicate either carcinoma or sarcoma. 2 We report a case of uterine carcinosarcoma arising from an endometrial polyp in a postmenopausal woman evaluated by 3-dimensional (3D) power Doppler angiography and positron emission tomography/computed tomography (PET/CT). Case ReportA 60-year-old multiparous postmenopausal woman was admitted to the Department of Gynecology at the Caracas University Hospital with postmenopausal bleeding and uterine prolapse. Her medical history was unremarkable. Uterine prolapse was confirmed at physical examination. Transvaginal sonography was performed and showed a heterogeneous 24-mm-thick endometrial stripe. The cervix was apparently normal, and the myometrialendometrial interface was well defined (Figure 1). Threedimensional power Doppler angiography was performed subsequently and showed a highly vascularized lesion with a main feeding vessel arising from the uterine fundus with an abnormal branching pattern, aneurysmatic dilatations, and distribution of vessels inside the uterine lesion (Figure 2). A polypoid malignant lesion with no myometrial invasion was suspected.

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Section: Discussionsupporting

confidence: 77%

Uterine Carcinosarcoma Arising From an Endometrial Polyp

Nieves-Lugo¹,

Blanch²,

Abad³

et al. 2006

Journal of Ultrasound in Medicine

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“…However, there are no specific criteria to differentiate leiomyosarcoma from benign leiomyoma prior to surgery. Although considered as not biological related, there are numerous studies which tried to differentiate a LM from a LMS on imaging, using MRI, PET or ultrasound examinations which provide no specific characteristics for a malignant tumor [10][11][12][13][14], and CT exam limited mainly for the evaluation of extrauterine metastases [10,15]. These data confirm once more that the decisive and accurate diagnosis is made by histological evaluation, other methods providing only suggestive features [10].…”

Section: Discussionmentioning

confidence: 81%

Diagnosis challenges in a uterine leiomyosarcoma

Balan¹,

Andriescu²,

Marin³

et al. 2017

Arch Clin Cases

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Uterine leiomyosarcoma (LMS) represents a rare tumor, accounting for 1.3% of all uterine malignancies. Although this tumor shares morphological and clinical features with other uterine benign and malignant tumors, the accurate diagnosis is necessary, due to their different biological behavior and prognosis. Therefore, we present a case of LMS in a 48 year-old patient, complaining of a 3-months metrorrhagia. The tumor presented as a poorly defined submucosal nodule, with a soft consistence and measuring 6 cm in diameter. The microscopic examination of this tumor nodule revealed fascicles of spindle cells, with pleomorphic hyperchromatic nuclei exhibiting moderate to severe atypia and areas of tumor necrosis. At least 5 atypical mitoses/ 10 HPF were also found. Immunohistochemistry technique, with a panel of six antibodies, comprising ER, PR, PCNA, SMA, p53, and bcl-2, has been performed for the differential diagnosis. The final histopathological diagnosis was that of uterine LMS. Considering LMS an aggressive tumor, the patient has been recommended a thorough follow-up.

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“…b) The results of FDG-PET examinations in patients with clinically suspected uterine malignancies based on the results of Pap smear tests, endometrial curettage or MRI, were also included when uterine malignancies were revealed by pathological examination. c) The results of previously reported sarcoma cases (9) were also included in this study. There were 15 cases in the LM A group, nine in the LA B group, 19 cases of EC, four of LMS, five of CS and one case of ESS.…”

Section: Methodsmentioning

confidence: 99%

“…It has been shown to be superior to MRI and/or computed tomography (CT) for evaluation of various malignancies (6). We have already reported on the usefulness of FDG-PET for the diagnosis of uterine sarcomas (7)(8)(9). However, several studies (10,11) have shown positive results for FDG-PET in cases of LM, and its usefulness in the differential diagnosis of LM and LMS is unclear.…”

Section: Introductionmentioning

confidence: 99%

Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas

Nagamatsu

Umesaki²,

Li³

et al. 2010

Oncol Rep

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Abstract. We evaluated the use of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) for the diagnosis of uterine sarcomas. FDG-PET combined with serum lactate dehydrogenase (LDH) levels were compared with FDG-PET alone for the diagnosis of leiomyosarcomas (LMS), which are the most difficult uterine sarcomas to diagnose. FDG-PET imaging of endometrial cancer (EC) was used as a reference. Immunoreactivity for glucose transporter-1 (GLUT-I) correlated with FDG uptake was evaluated in sarcomas and leiomyomas (LM), including cases not examined by FDG-PET. FDG was injected after at least 5 h fasting and standardized uptake values (SUVs) were analyzed quantitatively 50-70 min after injection. Immunohistochemical expression of GLUT-1 was studied in paraffin sections of tumors using anti-GLUT-1 antibodies and GLUT-1 expression scores were derived based on staining intensities. FDG-PET was performed preoperatively in a total of 53 patients including 10 with sarcomas, 19 with EC and 24 with LM. Immunohistochemical examination was performed in 17 sarcomas, 6 EC and 9 LM [6 usual LM, 1 uterine smooth muscle tumor of uncertain malignant potential (UMP), and 2 bizarre LM (BLM)]. SUVs for uterine sarcomas and EC were significantly higher (p=0.0001) than those for LMs. There were no significant differences in SUVs among ECs, carcinosarcomas (CS) and LMS. Significant differences in SUVs existed between LM and LMS (p=0.003). However, the diagnostic accuracy for LMS was only 73%. The diagnostic accuracy of FDG-PET combined with serum LDH was 100%. GLUT-1 expression scores were significantly higher in sarcomas and EC than in LM (p<0.0001). Intermediate GLUT-1 scores were found in two of the three cases of UMP and BLM. In conclusion, FDG-PET is useful for diagnosing uterine sarcomas, while FDG-PET combined with serum LDH is useful for diagnosing LMS. Immunohistochemical examination of GLUT-1 confirmed the high FDG uptake in LMS patients.

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Positron Emission Tomography with 18F-Fluorodeoxyglucose of Uterine Sarcoma: A Comparison with Magnetic Resonance Imaging and Power Doppler Imaging

Cited by 135 publications

References 9 publications

Uterine Carcinosarcoma Arising From an Endometrial Polyp

Uterine Carcinosarcoma Arising From an Endometrial Polyp

Diagnosis challenges in a uterine leiomyosarcoma

Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas

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